| Acute lung injiury(ALI)is lung tissue damage by Many lungs or extrapulmonary factors, Disease is emergency, Illness development is rapider,and fatality rate higher(25%-90%), Death is usually multiple organ failure, Pathogenesis of ALI is not definite..It is generally aceepted that ALI in essence is an excessive , Uncontrolled inflammatory response within the lung. High mobility group box proteinl(HMGB-1) is important of the late of inflammatory mediator. Studies in recent years show that there exists a delay in apoptosis of HMGB-1 in lung tissue during acute lung injury. Delay in apoptosis may lead to prolonged release of HMGB-1 Products and direct tissue injury, thereofre participate in the development of ALI.Incunabulum,High mobility group box protein 1(HMGB-1) as a DNA-Binding protein involved in DNA replication,repair,and transcription; and as a membrane-associated Protein that mediates neurite outgrowth.It is latest research that HMGB-1 may act as a late mediator of endotoxemia. When released by activated monocytes. It partieipates in the development of lethality and activates downstream cytokine release. As a proinflammatory cytokine,HMGB-1 is lethal to otherwise healthy animals. Elevated levels of HMGB-1 were observed in the serum of Patients with sepsis,and the highest levels were found in those Patients that died. The delayed kinetics of HMGB-1 release indicates that it may be useful to target this toxic cytokine in the development of future thearpies. Much evidence demonstrates that HMGB-1 has been linked to delayed endotoxin lethality.Objective::To study the change of serum HMGB-1 in patients with acute lung injury, and to determine its relation ship to APACHEⅡ, this paper discusses the changes of the level with MODS, I can with APACHEⅡscores of correlation, and whether it can predict the MODS the incidence and mortality. Methods: Take 10 cases of normal and 40 patients with acute lung injury patients after 1, 4, 7 days of serum HMGB - 1, determination it,and assess the MODS, I can with APACHE II scores. Based on the statistical analysis, understand HMGB - 1 level changes and the correlation between MODS, APACHEII divides, at the same time, the occurrence and assess OD mortality.Results: Experimental group than in the control group the expression of HMGB-1 levels were significantly higher, the difference was significant (P <.0.05). Comparison of experimental group: non-MODS group and the MODS group 1,4,7 days between the first expression of HMGB-1 levels were higher, (P <.0.05); non-MODS group serum levels of HMGB-1 expression in high in the control group, but lower than the MODS group, the group comparison: non-MODS group on day 4 HMGB-1 level was significantly higher than day 1 levels of HMGB-1 expression (P <0.01); the first 7 days with the clinical improvement of symptoms with the first 4 days HMGB-1 levels were significantly lower (P <0.01), even lower than on day 1; MODS serum HMGB-1 level was significantly higher, and continued for several days, the first 7 days than the first 4 days decreased but still higher than on day 1. 1,4,7 days after traumatic MODS score with HMGB-1 significantly different levels of dynamic change. 1,4,7 days after trauma APACHEⅡscore HMGB-1 significantly different levels of dynamic change. Correlation analysis showed that: HMGB-1 expression levels MODS score, APACHE II score was significantly related.Conclusion: (1)HMGB-1 showed a high expression in patients of after trauma acute lung injury,It as a late mediator of inflammation is often increased relatively late, and longer duration(.2)HMGB-l levels and concurrency MODS are closely related.(3)Routine testing of serum HMGB-1 after trauma and joint assessment of the level of MODS, APACHEII score contribute to the organ dysfunction after trauma prediction. |
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